Treating COPD With Medication

Types of Medications

How They Work

Examples of Medications

Possible Side Effects and Special Precautions

Bronchodilators

Fast-acting beta-2 agonists

• Relax and open airways

• Increase movement of cilia to help clear mucus

• Help prevent exercise-induced wheezing

• Help stop attacks

Inhaled:

HCI (Xopenex HFA); metaproterenol sulfate; terbutaline sulfate

albuterol sulfate (Ventolin HFA, Proventil HFA); levalbuterol

Trembling, nervousness, insomnia, fast heartbeat, or increased blood pressure. Should be taken before other bronchodilators and inhaled corticosteroids.

Long-acting beta-2 agonists

• Relax and open airways

• Take effect more slowly and work longer than fast-acting beta-2 agonists

• Increase movement of cilia to help clear mucus

• Help prevent exercise-induced wheezing

Inhaled: formoterol fumarate (Foradil); salmeterol xinafoate (Serevent)

Fast heartbeat, headache, nervousness, or trembling. Do not use for quick relief. Do not take more often than prescribed.

Anticholinergics

• Relax and open airways

• Take effect more slowly than fast-acting beta-2 agonists

Inhaled: ipratropium bromide (Atrovent HFA); tiotropium bromide (Spiriva)

Nervousness, dizziness, drowsiness, headache, upset stomach, constipation, or dry mouth.

Methylxanthines

• Stimulate the diaphragm and breathing

• May be useful if symptoms occur during sleep

• Are long-acting

Swallowed: theophylline (Elixophyllin, Theolair, Theochron, Theo-24)

Headache, nervousness, insomnia, irregular heartbeat, diarrhea, or nausea. Can interact with other medications. Blood levels must be monitored regularly. Limit caffeine intake.

Corticosteroids (These are not the same as the anabolic steroids used by some bodybuilders.)

Inhaled:

• Reduce inflammation and swelling in airways

• Reduce mucus production

• Decrease sensitivity of airways to irritants and allergens

Swallowed:

• Reduce inflammation and swelling in airways

• Reduce mucus production

• Decrease sensitivity of airways to irritants and allergens

Inhaled: beclomethasone dipropionate (QVAR); budesonide (Pulmicort); llunisolide (Areospan HFA); fluticasone propionate (Flovent HFA)

Swallowed: methylprednisolone (Medrol); prednisone (many brand names)

Inhaled: Very little enters bloodstream, so few side effects. Do not use for fast relief of shortness of breath. Must be used every day; rinse mouth and spit after use. Do not stop using without consulting your doctor. High doses must be tapered, not stopped abruptly.

Swallowed: Enter bloodstream, so may cause insomnia, mood changes, skin bruising, weight gain, stomach problems, high blood pressure, glaucoma, cataracts, osteoporosis, or high blood sugar. Long-term use may suppress immune system. Do not stop using without consulting your doctor. High doses must be tapered, not stopped abruptly.

Selective phosphodiesterase-4 inhibitors

• Suppress an enzyme that can cause inflammation in the airways

• Prevent worsening of COPD in people with severe COPD and chronic bronchitis

Swallowed: roflumilast (Daliresp)

Should not be used to treat sudden breathing problems. Diarrhea, weight loss, stomach pain, nausea, diminished appetite, headache, or dizziness may occur. Report any new or worsening symptoms to your doctor, such as mood or behavior changes, trouble sleeping, or if you feel impulsive or have disturbing thoughts.

Combination medications

• Combine effects of different types of medication

Inhaled: fluticasone propionate plus salmeterol xinafoate (Advair); budesonide plus formoterol fumarate (Symbicort); ipratropium bromide plus albuterol sulfate (Combivent)

Varies depending on medication. Talk with your health care provider.